It's safe to say that any woman who finds an unusual lump or swelling on their vagina should see their gynaecologist immediately. However, in many cases, the cause of the lump is something called a Bartholin's cyst, a mostly harmless and non-infectious condition that can be treated easily and effectively.

What is a Bartholin's cyst?

The Bartholin's glands are two small, largely invisible glands positioned on the vulva that secrete the fluid used to provide natural lubrication during sexual intercourse. However, these glands can become blocked, resulting in a swollen, tender mass known as a Bartholin's cyst. Most of these cysts are small, soft and painless, and may diminish on their own over time -- however, larger, badly inflamed cysts can cause significant pain, particularly during exercise or sexual intercourse.

Bartholin's cysts are not caused by bacteria, but in rare cases the cysts themselves can become infected, resulting in a Bartholin's abscess. This is a much more serious condition that requires prompt gynaecological treatment before the infection can spread and cause other complications.

How should I have a Bartholin's cyst treated?

As previously mentioned, any unusual lump on or in your vagina warrants a trip to the gynaecologist's office, in order to rule out other causes such as cancer. In most cases simple physical examination is enough to rule out a malignant growth, but in some cases the gynaecologist may wish to take a biopsy, a small sample of tissue which is taken from the cysts and examined for signs of disease.

If and when the lump is diagnosed as a Bartholin's cyst, treatment can begin -- or not. If the cyst is relatively small and does not cause you pain, your gynaecologist may recommend simply leaving the cyst alone. If kept clean and undamaged, most cysts will go away on their own. However, particularly large and/or painful cysts can be treated in a number of ways:

• Pain relief: If a cyst is causing you mild pain but does not warrant draining or opening, your gynaecologist may provide you with analgesic medication to relieve pain. Conventional oral medications are often used, and you may also be supplied with a topical, pain relieving gel to be applied directly to the cyst (these gels should not be applied to ulcerated or burst cysts). Your gynaecologist may also recommend that you take sitz baths, in order to relieve pain and keep the painful area clean.
• Draining: A cyst large enough to cause you problems can be drained using a catheter. These catheters are inserted into the cyst and used to hold the duct of the inflamed gland open, allowing the build-up of fluid to drain and returning function to the gland. Catheters must be left in for some time to allow the cyst to drain fully, but are not obtrusive -- however, your gynaecologist may ask you to abstain from sex while the catheter is inserted to prevent displacement.
• Opening: Particularly large cysts may not respond well to conventional draining, and may require opening. This is a simple surgical procedure, generally conducted under local anaesthetic, during which the cyst is cut open and stitched to unblock the duct. While this is a more invasive procedure with a longer recovery time, it results in immediate removal of the cyst rather than a gradual shrinking, and reduces the likelihood of the cyst returning.

For more information about these cysts and what you can do about them, contact your female gynaecologist.